Website of the Department of Health

Reform of the NHS

This is a very important transitional year as we continue to reform the NHS. Over the year we will place particular emphasis on:

We will be setting out the specific arrangements within which the NHS will work next year in a publication before the end of this month. This will describe, amongst other things, the delivery priorities, the payment by results and tariff details and the expectation on the development of practice based commissioning.

Transition leads

I am today announcing the appointment of 11 people who will lead the transition within clusters of SHAs. The transition leads will take on this responsibility from the beginning of February until, subject to consultation, new SHA leadership is in place. These clusters broadly conform to the government office of the regions boundaries and do not prejudice the outcome of consultation on the future shape of SHAs. The transition leads' task will be to oversee the creation of the new system over the next six months and specifically to oversee:

In each case the transition leader will be supported by a small team drawn from the locality and including people from public health, social care, nursing and other clinical staff and communications.

The precise arrangements will vary from area to area. However it will be essential to ensure that the leaders are creating a new system locally which works effectively with all our partners and particularly promotes joint working between health and social care and in the whole field of public health.

It is very important to stress that these arrangements will support the continuing authority of existing SHAs to discharge their responsibilities. Further details of the arrangements can be found attached at Annex A.

The following have kindly agreed to be transition leaders -

John Bacon   London

Mike Farrar  Yorkshire

David Flory  North East

Neil Goodwin  North West

Terry Hanafin Eastern

Thelma Holland South West (SW Peninsula and Dorset/Somerset)

Trevor Jones  South West (AGW)

Candy Morris  South East (Kent & Medway, Surrey and Sussex)

David Nicholson West Midlands

Nick Relph  South East (Thames Valley/Hampshire and IoW)

David Sissling East Midlands

I need to make it clear that taking up the transition leadership role is no indicator of who will take up substantive positions in new SHAs. 

The transition leaders will build on the work lead by Carolyn Regan, Chris Hannah, David Nicholson and Mike Farrar which has shaped the new roles of PCTs and the nature of commissioning.

• Download Annex A - Transition arrangements for SHA Clusters (PDF, 33K)

Social Care

The Secretary of State, Liam Byrne, Kathryn Hudson and myself have all welcomed the greater contact with social care leaders we have had over the last year and through the development both of the green paper and of the forthcoming white paper. We have recognised the need to strengthen the way in which the Department supports and develops social care.

We shall therefore be undertaking a review of the support needed for social care with the involvement of stakeholders by the end of February. Following this we will advertise for a Board level position on social care with a view to making an appointment by July.

Changes in the Department

At the same time we are changing the Department to make sure that we can both support and lead these changes. We will be immediately:

The key appointments here are that:

John Bacon will continue to act as Senior Responsible Officer (SRO) for the Connecting for Health programme.

Creating tomorrow whilst managing today

Some of these arrangements are transitional both in the NHS and the Department. We will follow this up by July with the:

Moving from delivery through performance management to delivery primarily through commissioning

These changes are all very important. They will equip us better for the challenges of the future. In particular they mark a transition in the NHS from delivery through performance management to delivery primarily through commissioning.

I know that these changes will take some time to bed in as we all learn to use the new levers for reform and improvement in the NHS.

Let me stress that the emphasis on commissioning as the main route for delivery does not in any way lessen the importance of continuing to improve and develop the care and services which are provided through all the many NHS organisations. The new Provider Development Director, 'the turnaround teams', the work of the NHS Institute for Innovation and Improvement, the work of Monitor and the Healthcare Commission and many others are all designed to support this improvement.

Equally important will be the growing emphasis on health and the working relationships with all our many partners in local authorities, voluntary organisations, private companies and the growing social enterprise sector.

Thank you

The NHS has progressed enormously over the last few years not only in the headline achievements - such as waiting lists, cardiac surgery or A and E - but in the very many small innovations and improvements led by determined staff in all parts of the country.

This success has been due to many thousands of front line staff but also the leadership offered by executives and non-executives alike, managers and clinicians, in all our many NHS organisations. Over the next period I know that a number of these leaders will be leaving the service. May I particularly thank them for the contribution they have made and the success they have created. This gives us all an excellent foundation for the next steps.

NIGEL CRISP